Bladder cancer has had its share of headlines recently.
Not because the public is uninformed about the disease or because scientists discovered a new wonder drug targeting bladder cancer cells. Rather, the disease keeps on reappearing under the adverse side effects category for one diabetes drug -- Actos.

We all know that diabetes has its own sets of health challenges, and to be bombarded by studies confirming a diabetes drug's bladder cancer risk brings chills to type 2 patients and their families.

But the truth is that Actos (known generically as pioglitazone) has been repeatedly linked to bladder cancer.

In June 2011, the Food and Drug Administration (FDA) required Takeda to update the Actos label to include a 40 percent increased risk for bladder cancer. The interim result of a study conducted by Kaiser Permanente in Northern California led to the FDA report. Around the same time, France and Germany decided to pull Actos from the shelves.

Doctors began prescribing Actos in the belief that it was a safer alternative to another diabetes drug in the thiazolidinedione (TZD) class -- Avandia (rosiglitazone). Once the most prescribed diabetes drug, Avandia lost its competitive advantage after a series of studies linked it to an elevated heart risk. In 2007, the FDA added a black-box warning for congestive heart failure (CHF) to both Avandia and Actos.

While the FDA is waiting for the final results of the Takeda-sponsored study to be released in early 2013, studies validating the Actos and bladder cancer link have been published one after another.”

In late May, the British Medical Journal (BMJ) published a study reinforcing the Actos-bladder cancer link, showing an 83 percent elevated risk for the diabetes drug users.

According to the study, the longer a person takes Actos and the higher the dosages, the higher the risk of bladder cancer. Researchers conducted the study with 115,000 diabetes patients who used Actos from 1998 to 2009. The four-year follow-ups revealed that 470 of the participants were diagnosed with bladder cancer.

Early this month, the Canadian Medical Association Journal (CMAJ) published a meta-analysis on 10 studies conducted with 2.7 million type 2 diabetes patients. Like BMJ, the study once again reiterated the link between Actos and bladder cancer. The only difference was that, this time, the study included Avandia in an effort to explore the link between bladder cancer and the TZD class in general. Researchers failed to find a link between bladder cancer and Avandia, however.

Actos is also linked to heart and liver failure, macular edema and bone fractures.

In the midst of these new developments, the FDA has approved the first generic form of Actos. Generic as it may be, it will carry the same active ingredient found in Actos, which causes bladder cancer.
Exercise, weight control and meal planning remain as the safest and most effective ways to regulate blood sugar levels. Prescription diabetes drugs, though they do not require much effort and discipline, have many side effects that can lead to another serious health conditions.